In order that the body can take in oxygen and give off carbon dioxide, both components of the respiratory bronchial system must function—the lungs as a gas-exchanging organ and the respiratory pump as a ventilation organ that transports air into the lungs and back out again. The breathing center in the brain, central and peripheral nerves, the osseous thorax and the breathing musculature as well as free, stable respiratory paths are necessary for a correct functioning of the respiratory pump.
In certain diseases there is a constant overload on or exhaustion of the respiratory pump. A typical syndrome is pulmonary emphysema with flat-standing diaphragms without the ability to contract. In the case of pulmonary emphysema the respiratory paths are usually extremely slack and tend to collapse. As a consequence of the flattened, over-extended diaphragms the patient cannot inhale deep enough. In addition, the patient cannot exhale sufficiently on account of the collapsing respiratory paths. This results in an insufficient respiration with an undersupply of oxygen and a rise of carbon dioxide in the blood, the so-called ventilatory insufficiency.
The treatment for inhalation difficulty often makes use of a breathing device. The so-called home respiration is an artificial respiration for supporting or completely relieving the respiratory pump.
The respiration can take place non-invasively via a tube and a nose mask or mouth mask that the patient can put on and take off as needed. However, this prevents the patient from breathing freely and speaking freely. In addition, a blocked tracheal cannula can be inserted into the trachea. This also has the consequence that the patient can no longer speak.
In the case of invasive respiration this usually occurs via a tracheostomy. This involves an opening placed in the trachea by an operation. A catheter about the diameter of a finger with a blocking balloon is inserted via the opening into the trachea and connected to a breathing apparatus. This makes a sufficiently deep respiration possible but prevents the patient from speaking. In addition to the respiration there is the transtracheal administration of oxygen via thinner catheters. U.S. Pat. No. 5,181,509 or 5,279,288 disclose corresponding embodiments. In this manner a highly dosed administration of oxygen is administered to the patient in a continuous stream with a permanently adjusted frequency. The flow of oxygen is regulated manually by a throttle device. However, simulation of the natural breathing process of a patient is not achieved because breathing is not deep enough. Also, the catheter end introduced into the trachea can result in irritations and a local traumatizing of the surrounding tissue in that it strikes against the trachea as a consequence of the respiratory movement or in that the surrounding tissue is dried out by the jet stream.
Furthermore, so-called “Montgomery T-tubes” are known that are inserted into the trachea. The patient can obtain oxygen via the shank of the T-piece run to the outside. In addition, the patient can draw off secretions himself if needed. The patient can breathe freely and speak when the front shank is closed; however, respiration is not possible via the Montgomery T-tube since the introduced air escapes upward into the buccal cavity or the pharyngeal area. An additional limitation of the above-referenced therapies is the impaired mobility of the patient because of inadequate ventilation as well as the bulk of the apparatus.
Therefore, there is an existing need for a respiratory system that provides a more efficient method for supporting the respiration of a patient and of creating an apparatus to this end that can also be taken along by the patient and is reliable in its use. Moreover, the there is a need for a tracheal prosthesis and a catheter that make possible a respiratory support synchronized with the spontaneous respiration of the patient without adversely affecting the patient's ability to speak.